Cancer is not a single disease. Even among tumours that arise in the same organ, there are many subtypes and, thanks to advances in the molecular diagnosis, the growing numbers of cancer subtypes are increasingly well defined. Oncologists have traditionally based recommendations for individual treatment on clinical and histological features that are an imperfect guide to how particular cancer patients will benefit from various therapies.

Molecular mechanisms responsible for uncontrolled growth can be completely different even in cancers that arise from the same organ. Furthermore they can change with time even in the same patient as the tumour evolves and adapts to treatment. To truly match therapy to the patient, the biological factors that drive tumour growth in specific cases need to be identified.

Most human cancers are caused by two to eight sequential alterations that develop over time. The evidence to date suggests that there are approximately 140 genes with intragenic Mutations that contribute to cancer. Cancer driver genes function through a dozen signaling pathways that regulate core cellular processes. Every single tumour, even of the same histopathologic subtype, is distinct with respect to its genetic alterations, but the pathways affected in different tumours are similar.

This E-learning module outlines the knowledge of molecular biology in solid cancers, emerging molecular technologies, essential principles in a treatment strategy that combines therapeutics with diagnostics and ensures technological advances application into the clinical setting.

Genetic heterogeneity should be assessed because it can significantly impact the response to therapeutics. The next-generation sequencing is a cost effective method for molecular diagnosis and identification of molecular heterogeneity and targets for therapy. It is expected that liquid biopsies will provide a method for evaluating tumour load and monitoring the response to therapy.

Much has been accomplished in personalising cancer care according to the biological and molecular characteristics of the tumour, but much remains to be done. Precision medicine and future progress in solid cancers require a multidisciplinary approach and an appropriate regulatory framework. Once new diagnostics and treatments are approved, it is essential to ensure timely and equal access to novel health technologies that can substantially improve the length and quality of life of cancer patients.

Cancer therapeutics are evolving rapidly, and ensuring that individual patients are not over- or undertreated, requires continuous evaluation of the available evidence and translating into clinical practice. Technological advances must be accompanied by increased education and training of all parties involved in cancer care and by the provision of relevant information to the patient community and to those who organise funding. This E-learning module is a part of ESMO strategy to educate medical professionals involved in cancer care about precision medicine.